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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVIII | Pages 83 - 83
1 Sep 2012
Chaudhary R Bell K Lapner P
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Purpose

Tenodesis of the long head of biceps is an established technique for management of biceps pathology including tears, instability, and chronic tendinosis intractable to non-operative management. Very few studies have reported on clinical outcomes of all-arthroscopic, non-interference, biceps tenodesis techniques. The purpose of this study is to evaluate the functional and quality of life outcomes of patients treated with an all-arthroscopic biceps tenodesis with a suture anchor.

Method

Case Series Level 4 Evidence

Fifty-eight (58) patients with a mean age of 58.5 years were treated with an arthroscopic biceps tenodesis in a single surgeons practice. A single suture anchor was used with a non-interference technique, either in isolation or in association with an arthroscopic rotator cuff repair. A retrospective analysis was performed on prospectively collected outcome measures on patients with a minimum one-year follow-up. Patients were evaluated with an ASES, Constant, and WORC scores pre-operatively and at 6 and 12 months post-operatively. In addition, patients were questioned post-operatively as to whether they experienced any biceps cramping, fatigue, or cosmetic deformity (popeye sign).


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVIII | Pages 173 - 173
1 Sep 2012
Chaudhary R Bell K Lapner P
Full Access

Purpose

An open superior capsular shift is a well-established technique for the management of patients with multidirectional shoulder laxity and the absence of a Bankart lesion. Few studies have reported on functional and quality of life outcomes using arthroscopic technique for shoulder stabilization using superior capsular shift in patients with no Bankart lesion. The purpose of this study was to assess the functional and quality of life outcome scores following shoulder stabilization with a selective arthroscopic superior capsular shift with suture anchors, for treatment of multidirectional laxity and the absence of a Bankart lesion.

Method

Case Series Level 4 Evidence

Thirty-six (36) patients with a mean age of 30.8 years, with a diagnosis of recurrent anterior atraumatic shoulder instability, and no Bankart lesion, were identified in a single surgeons practice. These patients underwent an arthroscopic shoulder stabilization with an anterior inferior to superior capsular shift. The labrum was arthroscopically released from the anterior/inferior glenoid and was shifted superiorly in conjunction with a capsular plication. A retrospective analysis was performed on prospectively collected outcome scores of patients who had with a minimum of 1 year of follow-up. The ASES and WOSI scores were administered pre-operatively and at 6 and 12 month follow-up. The presence of a positive post-operative apprehension sign was also recorded on follow-up.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_III | Pages 252 - 252
1 Jul 2011
Mathison C Chaudhary R Beaupré L Joseph T Adeeb S Bouliane M
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Purpose: The purpose of this study is to compare two fixation methods for surgical neck proximal humeral fractures with medial calcar comminution:

locking plate fixation alone and

locking plate fixation with intramedullary allograft fibular bone peg augmentation.

Method: Eight embalmed pairs of cadaveric specimens were utilized in this study. Dual energy X-ray absorptiometry (DXA) scans were initially performed to determine the bone density of the specimens. Surgical neck proximal humerus fractures were simulated in these specimens by creating a 1-centimeter wedge-shaped osteotomy at the level of the surgical neck to simulate medial calcar fracture comminution. Each pair of specimens had one arm randomly repaired with locking plate fixation, and the other arm repaired with locking plate fixation augmented with an intramedullary fibular autograft bone peg. The constructs were tested in bending to determine the failure loads, and initial stiffness using Digital Imaging Correlation (DIC) technology. The moment created by the rotator cuff was replicated by fixating the humeral head, and applying a point load to the distal humerus. A load was applied with a displacement rate of 4 mm/min, and was stopped approximately every 5 lbs to take a picture and record the load. This process was continued until failure of the specimens was obtained.

Results: The intramedullary bone peg autograft increased the failure load of the constructs by 1.57±0.59 times (p = 0.026). Initial stiffness of the construct was also increased 3.13±2.10 times (p = 0.0079) with use of the bone peg.

Conclusion: The stronger and stiffer construct provided by the addition of an intramedullary fibular allograft bone peg to locking plate fixation may help maintain reduction, and reduce the risk of fixation failure in surgical neck proximal humerus fractures with medial comminution.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 250 - 250
1 May 2009
Chaudhary R Beaupre L Johnston B
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To compare posterior cruciate ligament substituting (PCS) total knee arthroplasty (TKA) and posterior cruciate ligament retaining (PCR) total knee arthroplasty (TKA) to determine if greater overall flexion is obtained with the PCS TKA versus the PCR TKA at two year postoperative follow up. Secondarily, to determine whether there is a difference in the recovery of range of motion over time between the two groups from initial presentation, to discharge, and to follow up visits at three months, one year, and two years.

Prospective, randomised double-blind clinical trial consisting of one hundred male and female patients scheduled for primary TKA. Sample size allows detection of a difference of six degrees of knee range of motion using two-tailed tests, =0.05, and 0.20 (80% power). SCORPIO PCL substituting total knee system and the SCORPIO PCL retaining total knee system were implanted for evaluation in this study. Patients were assessed at initial presentation, at postoperative discharge from hospital, and at follow up visits at three months, one year and two years for flexion knee range of motion. Additional data were collected utilizing the WOMAC Osteoarthritis Index, the Knee Society Clinical Rating Scale, the SF-36, and the Knee Society Radiographic Evaluation as well as data on length of stay and surgical time.

Subjects were similar in demographic characteristics and all measurements at the baseline initial assessment. No differences were seen in knee flexion at two year follow up as measured using an independent t-test (p> 0.05). Recovery of knee range of motion over time was not different as measured using a two way repeated measures ANOVA (p=0.88 for group effect).

Postoperative flexion and recovery of kneww range of motion was not altered following TKA by using PCS or PCR prostheses.